Infectious Etiologies of Intussusception among Children <2 Years Old in 4 Asian Countries

Eleanor Burnett, Furqan Kabir, Nguyen Van Trang, Ajit Rayamajhi, Syed M. Satter, Jie Liu, Mohammad Tahir Yousafzai, Dang Duc Anh, Anupama Thapa Basnet, Meerjady S. Flora, Eric Houpt, Saqib Hamid Qazi, Tran Minh Canh, Anjana Karki Rayamajhi, Bablu K. Saha, Nasir Saleem Saddal, Sehrish Muneer, Pham Hoang Hung, Towhidul Islam, Syed Asad AliJacqueline E. Tate, Catherine Yen, Umesh D. Parashar

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)


Background: The etiology of intussusception, the leading cause of bowel obstruction in infants, is unknown in most cases. Adenovirus has been associated with intussusception and slightly increased risk of intussusception with rotavirus vaccination has been found. We conducted a case-control study among children <2 years old in Bangladesh, Nepal, Pakistan, and Vietnam to evaluate infectious etiologies of intussusception before rotavirus vaccine introduction. Methods: From 2015 to 2017, we enrolled 1-to-1 matched intussusception cases and hospital controls; 249 pairs were included. Stool specimens were tested for 37 infectious agents using TaqMan Array technology. We used conditional logistic regression to estimate odds ratio (OR) and 95% confidence interval (CI) of each pathogen associated with intussusception in a pooled analysis and quantitative subanalyses. Results: Adenovirus (OR, 2.67; 95% CI, 1.75-4.36) and human herpes virus 6 (OR, 3.50; 95% CI, 1.15-10.63) were detected more frequently in cases than controls. Adenovirus C detection <20 quantification cycles was associated with intussusception (OR, 18.59; 95% CI, 2.45-140.89). Wild-type rotavirus was not associated with intussusception (OR, 1.07; 95% CI, 0.52-2.22). Conclusions: In this comprehensive evaluation, adenovirus and HHV-6 were associated with intussusception. Future research is needed to better understand mechanisms leading to intussusception, particularly after rotavirus vaccination.

Original languageEnglish
Pages (from-to)1499-1505
Number of pages7
JournalJournal of Infectious Diseases
Issue number9
Publication statusPublished - 7 Apr 2020


  • Adenovirus
  • Intestinal obstruction
  • Intussusception
  • Rotavirus
  • Viral pathogens


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